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Outcome after stroke upon awakening.

Janel O Nadeau1, Jiming Fang, Moira K Kapral

  • 1Calgary Stroke Program, Department of Clinical Neurosciences, University of Calgary, Calgary, AB, Canada.

The Canadian Journal of Neurological Sciences. Le Journal Canadien Des Sciences Neurologiques
|July 16, 2005
PubMed
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Stroke occurring during sleep (stroke-on-awakening) is common. Patients who wake up with stroke have slightly worse functional outcomes, particularly those with subarachnoid hemorrhage.

Area of Science:

  • Neurology
  • Stroke Medicine
  • Epidemiology

Background:

  • Approximately 20-25% of all strokes occur during sleep, presenting with immediate deficits upon waking.
  • This study investigates the differences in outcomes between patients experiencing stroke-on-awakening and those who were awake at stroke onset.

Purpose of the Study:

  • To compare demographics, clinical characteristics, and six-month outcomes of stroke patients based on their stroke onset status (during sleep vs. while awake).
  • To identify factors influencing outcomes in stroke-on-awakening patients.

Main Methods:

  • Utilized data from the Registry of the Canadian Stroke Network (Phases 1 and 2).
  • Included all stroke types: ischemic stroke, transient ischemic attack, intracerebral hemorrhage, and subarachnoid hemorrhage.

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  • Employed descriptive statistics, multivariable logistic regression, and general linear modeling for comparative analysis.

    • Main Results:

    • Out of 2585 stroke patients, 13.5% experienced stroke-on-awakening.
    • Stroke-on-awakening patients exhibited higher blood pressure and a greater likelihood of ischemic stroke, with no difference in stroke severity (level of consciousness).
    • Mortality rates did not differ, but stroke-on-awakening patients were less likely to return home and had lower Stroke Impact Scale-16 scores.

    Conclusions:

    • Minor demographic and clinical variations exist between stroke-on-awakening and stroke-while-awake cohorts.
    • Functional outcomes are marginally poorer in the stroke-on-awakening group.
    • Subarachnoid hemorrhage significantly contributed to the poorer functional outcomes observed in stroke-on-awakening patients.